Reproductive - Pathology (2) Flashcards

Question

Common breast conditions * Acute mastitis * Definition * Treatment * Fat necrosis * Definition * Findings

Answer 1

* Acute mastitis * Definition * Breast abscess * During breast-feeding, increased risk of bacterial infection through cracks in the nipple * S. aureus is the most common pathogen. * Treatment * Treat with dicloxacillin and continued breast-feeding. * Fat necrosis * Definition * A benign, usually painless lump * Forms as a result of injury to breast tissue. * Up to 50% of patients may not report trauma * Findings * Abnormal calcification on mammography * Biopsy shows necrotic fat, giant cells.

Answer 2

* Definition * Common breast condition * Occurs in males [A]. * Results from... * Hyperestrogenism (cirrhosis, testicular tumor, puberty, old age) * Klinefelter syndrome * Drugs (**_S_**pironolactone, marijuana [**_Dope_**], **_D_**igitalis, **_E_**strogen, **_C_**imetidine, **_A_**lcohol, **_H_**eroin, **_D_**opamine **_D_**2 antagonists, **_K_**etoconazole). * **“**_S_**ome _Dope_ **_D_**rugs **_E_**asily **_C_**reate **_A_**wkward **_H_**airy _DD_ **_K_**nockers.”**

Answer 3

* Prostatitis * Dysuria, frequency, urgency, low back pain. * Acute * Bacterial (e.g., E. coli) * Chronic * Bacterial or abacterial (most common).

Answer 4

* Definition * Common in men \> 50 years old. * Hyperplasia (not hypertrophy) of the prostate gland. * Not considered a premalignant lesion. * Findings * Characterized by a smooth, elastic, firm nodular enlargement of the periurethral (lateral and middle) lobes, which compress the urethra into a vertical slit. * Often presents with increased frequency of urination, nocturia, difficulty starting and stopping the stream of urine, and dysuria. * May lead to distention and hypertrophy of the bladder, hydronephrosis, and UTIs. * Increased free prostatespecific antigen (PSA). * Treatment * α1-antagonists (terazosin, tamsulosin), which cause relaxation of smooth muscle * Finasteride.

Answer 5

* Definition * Common in men \> 50 years old. * Findings * Osteoblastic metastases in bone may develop in late stages, as indicated by lower back pain and an increase in serum ALP and PSA * Due to... * Arises most often from the posterior lobe (peripheral zone) of the prostate gland [A] * Diagnosis * Most frequently diagnosed by increased PSA and subsequent needle core biopsies. * Prostatic acid phosphatase (PAP) and PSA are useful tumor markers (increased total PSA, with decreased fraction of free PSA).

Answer 6

* Definition * Undescended testis (one or both) * Findings * Impaired spermatogenesis (since sperm develop best at temperatures \< 37°C) * Can have normal testosterone levels (Leydig cells are unaffected by temperature) * Decreased inhibin, increased FSH, and increased LH * Testosterone decreased in bilateral cryptorchidism, normal in unilateral * Associations * Associated with increased risk of germ cell tumors. * Prematurity increases the risk of cryptorchidism.

Answer 7

* Definition * Dilated veins in pampiniform plexus as a result of increased venous pressure * Most common cause of scrotal enlargement in adult males * Can cause infertility because of increased temperature * Findings * Most often on the left side because of increased resistance to flow from left gonadal vein drainage into the left renal vein * “Bag of worms” appearance * Diagnosis * Diagnosed by ultrasound with Doppler [A]. * Treatment * Varicocelectomy, embolization by interventional radiologist.

Answer 8

* Definition * ~95% of all testicular tumors. * Most often occur in young men. * Risk factors * Cryptorchidism, Klinefelter syndrome. * Findings * Can present as a mixed germ cell tumor. * Differential diagnosis for testicular mass that does not transilluminate * Cancer.

Answer 9

* Type of tumor * Testicular germ cell tumor * Definition * Malignant * Painless, homogenous testicular enlargement * Most common testicular tumor * Most common in 3rd decade, never in infancy. * Late metastasis, excellent prognosis * Findings * Painless, homogenous testicular enlargement * Large cells in lobules with watery cytoplasm and a “fried egg” appearance. * Increased placental ALP. * Radiosensitive.

Answer 10

* Type of tumor * Testicular germ cell tumor * Definition * Aggressive malignancy of testes, analogous to ovarian yolk sac tumor. * Most common testicular tumor in boys \< 3 years old. * Findings * Yellow, mucinous. * Schiller-Duval bodies resemble primitive glomeruli.

Answer 11

* Type of tumor * Testicular germ cell tumor * Definition * Malignant * Disordered syncytiotrophoblastic and cytotrophoblastic elements. * Findings * Increased hCG * Hematogenous metastases to lungs and brain * May present with “hemorrhagic stroke” due to bleeding into the metastasis * May produce gynecomastia or symptoms of hyperthyroidism (hCG is an LH and TSH analog).

Answer 12

* Type of tumor * Testicular germ cell tumor * Definition * Unlike in females, mature teratoma in adult males may be malignant. * Benign in children. * Findings * Increased hCG and/or AFP in 50% of cases.

Answer 13

* Type of tumor * Testicular germ cell tumor * Definition * Malignant, hemorrhagic mass with necrosis * Worse prognosis than seminoma * “Pure” embryonal carcinoma is rare * Most commonly mixed with other tumor types * Findings * Painful * Often glandular/papillary morphology. * May be associated with increased hCG and normal AFP levels when pure (increased AFP when mixed)

Answer 14

* Definition * 5% of all testicular tumors. * Mostly benign. * Leydig cell * Contains Reinke crystals * Usually androgen producing, gynecomastia in men, precocious puberty in boys. * Golden brown color. * Sertoli cell * Androblastoma from sex cord stroma. * Testicular lymphoma * Most common testicular cancer in older men. * Not a primary cancer, arises from lymphoma metastases to testes. * Aggressive.

Answer 15

* Definition * Lesions in the serous covering of testis present as testicular masses that can be transilluminated (vs. testicular tumors). * **Hydrocele** * Increased fluid 2º to incomplete obliteration of processus vaginalis * **Spermatocele** * Dilated epididymal duct

Answer 16

* Geography * More common in Asia, Africa, and South America. * Precursor in situ lesions * Bowen disease (in penile shaft, presents as leukoplakia) * Erythroplasia of Queyrat (cancer of glans, presents as erythroplakia) * Bowenoid papulosis (presents as reddish papules). * Associations * Associated with HPV, lack of circumcision.

Answer 17

* Definition * Painful sustained erection not associated with sexual stimulation or desire. * Associations * Associated with trauma, sickle cell disease (sickled RBCs get trapped in vascular channels), medications (anticoagulants, PDE-5 inhibitors, antidepressants, α-blockers, cocaine).

Reproductive - Pathology (2) Flashcards

(41 cards)